MONDAY: Medication Change


Copyright is held by the author.

MY PSYCHIATRIST told me there may be a one- or two-day period where I don’t feel myself, where I’m a little more anxious, where I feel some zaps in my brain on occasion. “It’s part of the process of switching antidepressants,” she told me. “Very normal.”

Instead, it feels like someone is burning holes in my skull. I can almost hear the sizzle as brain matter is eaten away. My body shakes during the day, and at night it feels like someone is drawing a comb across my skin.

My obsessive thinking came roaring back with the physical symptoms. I cannot stop thinking about death by drowning, when the waters eat away at the country thanks to the rising sea levels. Sometimes, I can taste seawater in my mouth. I almost drowned once, as a kid, when my mother took me to the beach. Maybe that is the cause of these vicious thoughts, my origin story. Or maybe I was damned at birth to be plagued with obsessions.

Why couldn’t I just be worried about washing my hands, though? Instead, every time I go to the sink, I picture it overflowing with water, filling up my one-bedroom apartment, filling up my lungs. I’ve had this fear for two decades, but today it’s worse than it has been in years. Today, I feel like I cannot breathe.

I pace back and forth in my apartment. The rain smacks against my wall-to-wall window. The sound of water is the last thing I need. My skin prickles, and I feel warmth in my chest, but not a good warmth, not the kind when you fall in love; instead, it’s the sign of panic coming on.

I leave my living room and turn into my kitchen. I open the cabinet above the sink, grab a bottle of Xanax, and pop one, then two, then three. Anything to make myself relax. I lean against the counter, telling myself this isn’t rational, telling myself that in a day or so I will be fine. On some level, I know this is true, but that level is too deep, and my mind is on fire.

My gaze falls on the electrical socket next to my garbage pail on the far side of the kitchen. I imagine water seeping out of it, then gushing out, then filling the room, then drowning me. In my mind’s eye, I’m dead. That last part I’m not as upset about as I should be.


It is not irrational to worry about climate change many a therapist told me. But it’s not rational to worry about the waters suddenly flooding your apartment.

Is that true, though? Not if you read recent reports. Scientists are waiting for a big event, a cataclysmic moment that will mark a point of no return for humanity. Perhaps the sea really will overtake everything as the glaciers melt all at once. A Biblical event in which we are all washed away for our sins. Maybe it’s not that my fears are irrational; maybe it is that I am the only rational person on Earth, which is a curse in itself.

This pondering is not helpful, but I cannot stop my mind from racing. I throw myself onto the couch (which, unfortunately, faces the window currently being pelted with water) and scream into my pillow, hoping to let out some stress, but all that comes is a shriek that sounds less than masculine. How I’ll make it through another night of this I have no idea.

It’s time to give in and call my psychiatrist again.

“It’s Bernard Fitzpatrick,” I tell the assistant who answers.

“Hello, Bernard, how are you?” The friendliness in her voice is real. She knows me well. I am embarrassed by that.

“I need to speak to Dr. Georges,” I say. “Having some more medication problems.”

The assistant tells me she will check if the doctor is free. After a moment, the doctor comes on. “Bernard, are you all right?”

“Dr. Georges,” I say, almost scream. “I’m so glad to catch you. I’m having some issues. My mind is all over the place. I don’t think the new medicine is working yet.”

“Sometimes that happens with the switch, remember?”

“Yes, we talked about that, but this is . . .” I search for an effective word, my mind going blank. “This is bad. Worse. It’s worse than I thought it would be. I’m having trouble. I’m in a dark place.”

“Are you suicidal?”

I consider that horrible question for a moment. I so often picture my own death by drowning, but is that suicidal? “I don’t think so,” I say. “I just keep fixating on terrible thoughts. It’s hard for me not to. Impossible, really.”

“And you’re taking your Xanax?”

I nod, then realize she can’t hear that. “Yes, absolutely. It’s not doing much, but I’m scared to take more than two milligrams.” Well, three milligrams, but it’s all the same.

“That’s responsible of you. You should come in. I’m out tomorrow for the fourth of July, but I’ll have something for Saturday. I’ll have Clara arrange it.”

I talk again to the assistant. We set up for Saturday at 11 am. I thank her and then thank her again.

I breathe a sigh of relief. I fall asleep.


I dream of water going down my throat, filling my stomach, violating every part of me, making me so bloated I explode. The remnants of my body float away, down a cascading river that begins to eat all of civilization.


I wake up. It’s night, and it’s still raining. If anything, the rain comes down harder than earlier. It sounds like bullets. Ra-ta-ta-ta-ta. For a moment, I think it’s hitting my apartment door, too, hitting all four walls, in fact, but I know that’s irrational. Water does not work like that. Yet to know something is irrational does not necessarily end the fear. In fact, it could make it worse. How could knowing your mind is thinking irrationally not make you more afraid?

I stand up. Laying down for too long causes more anxiety, as if the fears have time to settle. I rub my eyes and curse at myself for sleeping so long. How am I supposed to make it through the night, the worst part of the day, if I can’t sleep? I’ll lose it. I’ll lose my mind.

“Stop being dramatic,” I mutter. I should probably call my psychiatrist’s emergency line if I’m getting this bad, but I feel intense guilt at the idea of bothering her yet again. I can tough out another day of this. I’ve gone through worse even if I can’t recall when right now. But I’m sure I have, right?

The buzz of my intercom slices through my thoughts. I go over to the wall, just before the kitchen entrance, and tap it. “Hello?”

“It’s Bill.” The voice is tinny, the connection poor.

“I think you have the wrong apartment,” I reply. I’m sweating, but I’m not sure why. Something about the voice bothers me.

“Isn’t this Robert Seagrad?” There’s aggression in his tone.

“No,” I say.

“Motherfucker,” the man snarls. The intercom cuts off. My nerves go on fire, and I wrap my arms around myself, wishing there was someone else here to comfort me. My brain goes into overdrive. I picture water coming out of the intercom’s speaker. Angry seawater that wants to fill up my apartment, that wants to drench everything, that wants to drown me. The liquid has been around for thousands of years, since Earth’s beginning, and it’s been waiting to kill me.


I’m sitting on the couch, taking in a few deep breaths. An old technique. The man on the intercom rattled me. On another night, I could have laughed the mix up off. Not tonight. Tonight, my mind betrays me. What if he thinks I was lying? What if he thinks I really am this Robert Seagrad? What if he comes up here and tries to kill me? What if I actually am Robert Seagrad, but my medication change has gone so wrong that I’ve convinced myself I am somebody else?

God damn it. I need to pull my shit together. Jogging sometimes helps, but the rain prevents that. Can you imagine me out in the rain? Madness, just madness. Instead, I drop to the floor and do twenty push-ups. I break for a moment and do twenty more. A sweat is building, the good kind, not the one that comes from terror. I can feel my mind relaxing thanks to exertion. Only so much it can focus on at once. But still, the thoughts crawl through. I want another Xanax, but I’m thinking I’ll have to dry swallow it. I don’t want to turn on the faucet, too afraid I won’t be able to turn it off, that sludge will come out.

There’s a knock at the door. I walk over and look through the peephole.

On the other side of the door is a man who might be me, although he’s wearing a suit with a black tie, blacker than should be possible. He opens his mouth and a snake of water slithers out. It’s unending, going down the front of his chest, onto the ground. Another one comes out, this one going up his face, leaving droplets on his cheeks. A sound starts to emanate from him, a moan that turns into a shriek. The figure comes forward, pushing its mouth up against the peephole. For a moment, I see an abyss, one that can devour me, one where water rules over all. A shriek comes, but I am not sure if it is from the man, me, or both of us as we drown.

In that moment, in the back of my mind, I acknowledge how good it is that I do not own a gun for I would have shot myself.

I collapse.


When I open my eyes, I think it’s raining from below, the water shooting out of the floor, hitting the ceiling. A moment of terror comes, real terror, when you feel insignificant and you know your life is nothing. It passes, and I realize there is in fact liquid below me. I’ve wet myself. I laugh in hysteric relief. I have no idea how I’ll clean myself up. How could I possibly go into the shower with the thoughts that run through my mind?

I push myself up and begin to strip down. The least I can do is get out of these clothes. I dump them in the tub, planning to wash them once I finally feel better, and use a wet washcloth to clean myself. I look away as I turn on the faucet briefly, but I’m impressed that I could turn the faucet on at all. That’s progress. You have to note progress, a therapist once told me.

After scrubbing myself clean, I call my psychiatrist, my guilt be damned. “Hey, doctor,” I say to her voicemail. “I’m having some more serious problems. I actually collapsed. I think it’s not just the medication switch. The new medicine is doing something to me. I’m not going to take it until I hear from you, I think.”

I sit on the couch, still nude, and put my head in my hands. My mind is a little quieter now, and it allows me the chance to cry. The sobs come soft but consistent. I’d been hoping this new medicine would work better, but instead it’s turned my brain into an inferno. I wonder how people like me survived before medication. Maybe they didn’t.

My hands are wet with my tears. The salt in them reminds me of seawater. I start to laugh at the fact that saltwater has been forever inside of me and, eventually, I fall asleep.


I wake up in the middle of the night to see it’s still raining. I pick myself off the couch and let loose a sigh that has the power of a hurricane’s wind. What a night. But I’m surviving it. I’m surviving it. That’s something. It’s one more day I can say I have gotten through. There’s pride to be found in that fact.

I retreat to my bed, hoping for a more rational tomorrow.


Image of Douglas McCarthy

Donald McCarthy is a writer and teacher from New York. For a complete look at his publications visit

  1. Thanks for sharing this Donald.
    It is a very solitary journey.
    All the best to you.

  2. My impression is that this piece is way too repetitious and the plot doesn’t develop. I also query ‘cries that sound less than masculine’; I see that it fit into the narrative. Cheers. Mel

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